Gender Disparities in Pain and Treatment and their Association with Alzheimer's Disease and Related Dementias (ADRD)

项目总结/摘要 我是内科老年医学和姑息医学系的助理教授， 德克萨斯大学医学分支的一名医生我的长期职业目标是成为一名独立研究员 他确定了老年痴呆症患者健康方面性别差异的驱动因素和后果， 疾病和相关痴呆（ADRD），将生命过程社会和健康结构与临床细节相结合 医疗索赔。为了实现这一目标，我将完成以下四个培训目标 我之前在衰老流行病学方面的培训：（1）了解影响疼痛和ADRD的复杂过程 （2）学习性/性别背景和按性别分析结果的技术， 关注疼痛和ADRD的性别和性别差异;（3）发展分析医疗保险的统计技能 与调查数据相联系的索赔数据;以及（4）提高作为 通过培养辅导和领导技能， 手稿和赠款申请，以及领导技能。这些领域的培训将包括课程， 在临床环境中跟踪跨学科团队，以及访问，管理和分析的经验 医疗保险文件。我的培训活动已与一个研究项目相结合，在该项目中，我将使用来自 健康与退休研究是一项针对美国老年人的全国性纵向研究， （A）评估医疗保险索赔中的性别差异（2006-2018年），以完成以下具体目标： 通过比较调查数据中的疼痛自我报告与调查数据中的慢性疼痛诊断， 按ADRD状态列出的老年人索赔数据;（B）检查慢性疼痛治疗中的性别差异 在患有疼痛的老年人中，按ADRD状态;和（C）评估慢性疼痛与 疼痛和ADRD事件的疼痛治疗。这项研究的预期结果将提供证据， 疼痛和疼痛治疗作为ADRD的可改变风险因素，并为潜在的疼痛治疗干预提供信息 旨在缩小男女之间的治疗差距，并最终缩小 ADRD负担。完成K 01指导培训和研究计划将为我提供知识， 了解ADRD老年人之间的差异所需的技能和专业知识，以便制定一个 一项研究计划，将生命过程中的社会和健康结构与临床数据相结合，其目标是 减少患有疼痛和ADRD的老年人之间的性别差异。

PROJECT SUMMARY/ABSTRACT I am an Assistant Professor in the Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, at the University of Texas Medical Branch. My long term-career goal is to become an independent researcher who identifies drivers and consequences of gender disparities in health among older adults with Alzheimer’s disease and related dementias (ADRD), blending life course social and health constructs with clinical details from medical claims. To accomplish this goal, I will complete the following four training objectives that build upon my prior training in the epidemiology of aging: (1) Understand the complex processes that impact pain and ADRD among older adults; (2) Learn context of sex/gender and techniques to analyze results by sex and gender, with a focus on sex and gender differences in pain and ADRD; (3) Develop statistical skills for analyzing Medicare claims data linked to survey data; and (4) Increase competencies required to function effectively as an independent extramurally-funded investigator, by developing mentoring and leadership skills and enhancing manuscript and, grant applications, and leadership skills. Training in these areas will include coursework, shadowing interdisciplinary teams in clinical settings, and experiences accessing, managing, and analyzing Medicare files. My training activities have been integrated with a research project in which I will use data from the Health and Retirement Study, a nationally representative longitudinal study of older adults in the US, linked to Medicare claims (2006-2018) to complete the following specific aims: (A) Evaluate gender differences in the underdiagnosis of pain by comparing self-reports of pain from survey data to the diagnosis of chronic pain from claims data in older adults, by ADRD status; (B) Examine gender disparities in the treatment of chronic pain among older adults with pain, by ADRD status; and (C) Assess gender disparities in the association of chronic pain and pain treatment with incident ADRD. The expected findings of this research will provide evidence for pain and pain treatment as a modifiable risk factor for ADRD and inform potential pain treatment interventions aimed at reducing the treatment gap between men and women and ultimately reducing the gender disparity in ADRD burden. Completion of the K01 mentored training and research plans will provide me with the knowledge, skills, and expertise required to understand disparities among older adults with ADRD, in order to develop a program of research that blends life course social and health constructs with clinical data, with the goal of reducing gender disparities among older adults with pain and ADRD.